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Do Probiotics Interfere With Coumadin?
Probiotics are "friendly" bacteria that live naturally in the body, but do not cause disease 1. They keep harmful bacteria in check and help with digestion. Probiotics also occur in certain fermented foods, such as yogurt, and are available in supplements 1. Consult your doctor before consuming probiotic supplements or significant amounts of probiotic-containing foods if you also use the anticoagulant medication warfarin, commonly known as the brand Coumadin.
Probiotic Uses
Probiotics are available in various formulations 1. Different species of lactobacillus are common ingredients 2. Probiotic supplements containing lactobacillus may be effective for uses such as treating certain types of diarrhea, ulcerative colitis, irritable bowel syndrome and bacterial vaginal infections, according to U.S. National Library of Medicine website MedlinePlus 2.
Coumadin
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Coumadin reduces the clotting ability of the blood, making it useful for preventing blood clots in people at risk. It also can stop existing clots from growing larger. Examples of risk factors for blood clots include having an irregular heart rhythm or having experienced a heart attack. If you take Coumadin, you need regular blood tests, including one called the international normalized ratio, or INR 3. The INR measures the time it takes for your blood to clot as compared to an average.
- Coumadin reduces the clotting ability of the blood, making it useful for preventing blood clots in people at risk.
- If you take Coumadin, you need regular blood tests, including one called the international normalized ratio, or INR 3.
Primary Coumadin Risk
Taking Coumadin increases the risk of bleeding, and combining it with medications or supplements that have anticoagulant effects elevates the risk further. Probiotics do not have this effect 1. Authoritative websites do not caution against taking probiotic supplements when using Coumadin, but one potential issue calls for a consultation with your doctor beforehand.
Vitamin K
Does Vitamin C Affect Coumadin?
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Research is scant on specific commercial probiotic formulations, notes Drugs.com 1. As of 2011, no studies have focused on people taking both Coumadin and probiotics, according to medical doctor Timothy S. Harlan at his Dr. Gourmet website 14. A potential problem involves the production of vitamin K by probiotic bacteria, cautions Harlan. Vitamin K increases blood clotting ability. If you take Coumadin, you need to keep vitamin K levels in your body relatively steady, because fluctuations may boost or interfere with the medication's effects. This doesn't necessarily mean you can't take probiotics when using Coumadin, but you may need closer blood monitoring at first and a change in your medication dosage 14.
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References
- Drugs.com: Probiotics
- MedlinePlus: Lactobacillus
- Heart Rhythm Society: International Normalized Ratio
- Dr. Gourmet: Coumadin and Probiotics
- National Center for Complementary and Integrative Health. Probiotics: What you need to know. Updated August 2019.
- Su G, Ko C, Bercik, P, ET al. AGA clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders. Gastroenterology. June 9 2020. doi:10.1053/j.gastro.2020.05.059
- Didari T, Mozaffari S, Nikfar S, Abdollahi M. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World J Gastroenterol. 2015;21(10):3072-3084. doi:10.3748/wjg.v21.i10.3072
- Homayouni A, Bastani P, Somayeh Z, et al. Effects of probiotics on the recurrence of bacterial vaginosis: A review. Low Genit Tract Dis. 2014 Jan;18(1):79-86. doi:10.1097/LGT.0b013e31829156ec
- Falagas ME, Betsi GI, Athanasiou S. Probiotics for prevention of recurrent vulvovaginal candidiasis: a review. J Antimicrob Chemother. 2006;58(2):266-72. doi:10.1093/jac/dkl246
- Floch MH, Walker WA, Madsen K, et al. Recommendations for probiotic use-2011 update. J Clin Gastroenterol. 2011;45 Suppl:S168-71. doi:10.1097/MCG.0b013e318230928b
- Doherty G, Bennett G, Patil S, Cheifetz A, Moss AC. Interventions for prevention of post-operative recurrence of Crohn's disease. Cochrane Database Syst Rev. 2009;(4):CD006873.doi:10.1002/14651858.CD006873.pub2
- National Institutes of Health Office of Dietary Supplements. Probiotics. Updated une 26, 2019.
- Cai, J.; Zhao, C.; Du, Y. et al. Comparative efficacy and tolerability of probiotics for antibiotic-associated diarrhea: Systematic review with network meta-analysis. United European Gastroenterol J. 2018 Mar; 6(2): 169-80. DOI: 10.1177/2050640617736987.
Writer Bio
Shelley Moore is a journalist and award-winning short-story writer. She specializes in writing about personal development, health, careers and personal finance. Moore has been published in "Family Circle" magazine and the "Milwaukee Sentinel" newspaper, along with numerous other national and regional magazines, daily and weekly newspapers and corporate publications. She has a Bachelor of Science in psychology.